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Mar 20, 2025; e14608.

A Bootstrap Method to Estimate Cost of Behavioral Intervention Implementation: A Proof of Concept.

Julia Mo, Daniel Maeng, Mark C Hornbrook, Virginia Sun, Ruth C McCorkle, Ronald S Weinstein, Robert S Krouse
Author Information
  1. Julia Mo: Department of Medicine, University of Rochester Medical Center, Rochester, New York, USA. ORCID
  2. Daniel Maeng: Department of Psychiatry, University of Rochester Medical Center, Rochester, New York, USA.
  3. Mark C Hornbrook: Center for Health Research, Kaiser Permanente Northwest Region, Portland, Oregon, USA.
  4. Virginia Sun: Division of Nursing Research and Education, City of Hope, Duarte, California, USA.
  5. Ruth C McCorkle: School of Nursing, Yale University, West Haven, Connecticut, USA.
  6. Ronald S Weinstein: Arizona Telemedicine Program, University of Arizona, Tucson, Arizona, USA.
  7. Robert S Krouse: Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA.
PMID: 40110768 DOI: 10.1111/1475-6773.14608

Abstract

OBJECTIVE: To develop a bootstrapping method to augment time-driven activity-based costing (TDABC) analysis intended to allow more realistic cost estimates.
DATA SOURCES: Secondary data from a multisite clinical trial conducted from 2016 to 2018 on an ostomy self-management telehealth intervention for cancer survivors.
STUDY DESIGN: The intervention cost was newly estimated by incorporating expected patient participation rates calculated via bootstrapping. This cost was compared against the cost estimate obtained via traditional TDABC.
DATA COLLECTION: Study personnel self-reported the time spent on each activity associated with the intervention. We also utilized patient participation data collected from the trial.
PRINCIPAL FINDINGS: The total cost of the telehealth intervention estimated via the bootstrapping method was $210,052.62 (95% CI: 208,652.13, 211,402.51), with an average cost per participant of $1981.63 (95% CI: 1968.42, 1994.36). Traditional TDABC analysis yielded $186,363 or $1758 per participant. Further adjusting assumptions about the cost of the postintervention monitoring phase, our approach yielded an alternative estimate of $176,362.56 (95% CI: 174,962.07, 177,712.45) and an average cost per participant of $1663.80 (95% CI: 1650.59, 1676.53) suggesting both methods yielded similar bottom-line results.
CONCLUSIONS: Incorporating bootstrapping into traditional TDABC methodology is feasible and is likely to capture variance in clinical trial data.

Keywords

behavioral interventions bootstrapping cost methods economic modeling time���driven activity���based costing

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Grants

  1. CDR-1507-31690/Patient-Centered Outcomes Research Institute
Journal Article

Word Cloud

Created with Highcharts 10.0.0costbootstrappingTDABCintervention95%CI:datatrialviaperparticipantyieldedmethodcostinganalysisDATAclinicaltelehealthestimatedpatientparticipationestimatetraditionalaveragemethodsOBJECTIVE:developaugmenttime-drivenactivity-basedintendedallowrealisticestimatesSOURCES:Secondarymultisiteconducted20162018ostomyself-managementcancersurvivorsSTUDYDESIGN:newlyincorporatingexpectedratescalculatedcomparedobtainedCOLLECTION:Studypersonnelself-reportedtimespentactivityassociatedalsoutilizedcollectedPRINCIPALFINDINGS:total$210052622086521321140251$198163196842199436Traditional$186363$1758adjustingassumptionspostinterventionmonitoringphaseapproachalternative$176362561749620717771245$166380165059167653suggestingsimilarbottom-lineresultsCONCLUSIONS:IncorporatingmethodologyfeasiblelikelycapturevarianceBootstrapMethodEstimateCostBehavioralInterventionImplementation:ProofConceptbehavioralinterventionseconomicmodelingtime���drivenactivity���based

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